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A case of shunt responsive tremor due to normal pressure hydrocephalus

Version 2 2024-06-05, 08:17
Version 1 2020-05-01, 09:30
journal contribution
posted on 2024-06-05, 08:17 authored by Aron HillAron Hill, MW Cowey, DR Williams
Hydrocephalus refers to an abnormal accumulation of cerebral spinal fluid (CSF) within the brain resulting in enlarged ventricles and subsequent distortion of periventricular structures [ 1 ], while normal pressure hydrocephalus (NPH) is a specific form of communicating hydrocephalus where intra-ventricular CSF pressure remains in the normal range. As only a small disparity in pressure between the ventricles and surrounding subarachnoid space are needed to trigger absorption of interstitial fluid, ventricular enlargement still occurs in this condition [ 2 ], which is typically accompanied by symptoms of gait disturbance, urinary incontinence and cognitive impairment [ 3 ]. Although a number of movement disorders have been described in patients with hydrocephalus [ 4 ], the occurrence of tremor is a rare finding, which has consequently received very little attention in the literature and warrants further investigation. Here we present a case of an appendicular, predominantly lower-limb tremor occurring in a patient with concomitant idiopathic NPH, which demonstrated a marked reduction in amplitude following the insertion of a ventriculo-peritoneal shunt. The potential mechanisms underlying this clinical presentation are also discussed.

History

Journal

Journal of the Neurological Sciences

Volume

347

Pagination

413-415

Location

Amsterdam, Netherlands

ISSN

0022-510X

eISSN

1878-5883

Language

eng

Publication classification

C4 Letter or note

Copyright notice

2014, Elsevier

Issue

1-2

Publisher

Elsevier